Serup Jørgen, Lindblad Asa Kettis, Maroti Marianne, Kjellgren Karin I, Niklasson Eva, Ring Lena, Ahlner Johan
Department of Dermatology, Linköping University Hospital, Sweden.
Acta Derm Venereol. 2006;86(3):193-7. doi: 10.2340/00015555-0073.
Creams, ointments and solutions applied to the skin surface by patients as part of a daily routine might be expected to provide a more variable dosage than do standard tablets. However, adherence to treatment in dermatology has been little studied. This article reviews recent publications in the field. These are dominated by questionnaire-based studies, which tend to over-estimate adherence. Reduced adherence to dermatological treatment is noted in 34-45% of patients. It is likely that the percentage of patients who practice truly optimal treatment in their daily life is even lower considering the variable practice of self-treatment. Self-reported psychiatric morbidity contributes to poor adherence to dermatological treatment, while a well-functioning doctor-patient interaction is a major determinant of good adherence, as is patient satisfaction. In conclusion, adherence to dermatological treatment is unsatisfactory and there is a need for intervention and change in clinical routines. The therapeutic and economic benefits may be considerable. The immediate challenge is to stimulate a change in patient behaviour and improve self-treatment at home.
患者作为日常护理一部分涂抹于皮肤表面的乳膏、软膏和溶液，其剂量可能比标准片剂更不稳定。然而，皮肤科治疗的依从性研究较少。本文综述了该领域最近的出版物。这些研究主要是基于问卷调查的，往往高估了依从性。34%至45%的患者皮肤科治疗依从性降低。考虑到自我治疗的差异，在日常生活中真正进行最佳治疗的患者比例可能更低。自我报告的精神疾病会导致皮肤科治疗依从性差，而良好的医患互动是依从性良好的主要决定因素，患者满意度也是如此。总之，皮肤科治疗的依从性不尽人意，需要对临床常规进行干预和改变。其治疗和经济效益可能相当可观。当前的挑战是促使患者行为发生改变，并改善在家中的自我治疗。
